Saturday, July 12, 2008

My New Name

I hadn't realized it but apparently I've changed my name to "The Agency Nurse".

I know, I know. We're the scum of the earth. Pulled from the flotsam and jetsam of nursing pools all over the country. We're all money grubbing, over-paid, under-qualified, who-knows-what-kind-of-background, shady RN's who are probably running from the law or some probationary-license hearing in another province.

I stood in the ER department waiting room in my green OR scrubs* for 20 minutess, wearing stethoscope and ID badge (giving what I thought would be indications that I was there to work and not for a sore throat) before someone acknowledged me. And I knew they weren't so busy that they couldn't say "hi--we'll be right with you" which is something I always endeavor to do when I am on the other side of the desk no matter how crazy it is. This power play of "I'll stop pretending I don't see you when I feel good and ready" is complete BS in my mind.

Finally someone lets me in, and I am off and running.

Or rather standing at the nursing desk twiddling my stethoscope.

So I make myself busy by seeking out the things I always locate first when in a new ED:

salbutamol
ipratropium
naloxone
epinephrine
diphenhydramine
glucometer
peds/adult NRB
peds/adult neb mask
ETOH swabs
IV start kit
NS bags
crash cart (and how to take it apart)
narcotics (and keys to same)

Now I can breathe a bit easier.

So I wander around like a tool, hear my new name "The Agency Nurse" being uttered every now and again. I think, "whatev...you don't know me" because they don't.

And the worst thing is the agencies exacerbate this problem by sending medical nurses or dialysis nurses to work in ICU's or ER departments which makes all the staff nurses pretty sure that if you are "agency" you have no idea how ED's work and you (in turn) are only going to make more work for them (while making more $ per hour).

After about an hour the PCC (manager) came on the floor and said "I know YOU!"


I had worked in this ED in November of 2006 for a couple of weeks. Her first shift in the hospital was covering night manager, and it was my second shift in the department. The other night nurse had called in sick so I was alone with a full ER and a full waiting room. It was fun at first but then things got really hairy and I had to call her to the department to help out. We ended up having an absolutely insane night: young woman with 3rd degree grease burn, an M.I, 3 psyche patients who were completely psychotic and had to be in restraints, all on top of the usual ER stuff like abdo pains, little old ladies, etc.

Anyway, she points at me and says (in front of other RN's, MD, MD student) "We had such a blast that crazy night! Remember the burn and the MI that came in at the same time?? Oh it's great to have you back!"

OK so now at least I had a bit of street cred.

Still no one else actually talked to me for the rest of the shift, which I was expecting. They still didn't call me by my name.

Ding! Ding! Ding!

Round 2 starts in t-5 hours.

Wish me luck (or blog fodder at least).

*I have old OR scrubs from hospital X that I 'borrowed' because I got in a MASSIVE argument with the head of infection control over the fact that the hospital provided clean scrubs (and bins to put dirty ones in) for the CCU, ICU, cath lab, OR, and dialysis staff but NOT THE ER staff. That means we wear our own scrubs to work and take then filthy-covered-in-who-knows-what back into our HOMES.
OK, excuse me? Does anyone else see a problem here? When we get patients we don't know yet if they have MRSA, VRE, TB, scabies, etc. etc. So we take care of these people for our shift then wear those clothes home. All the other dept have the luxury of time to tell them what little critters folks are bringing with them to the hospital and so can glove and gown etc. accordingly.
The infection control woman told me that

"as an ER nurse I should be using universal precautions with everyone".

Someone slap me! I have never thought of that!

So I asked her if universal precautions meant gloving, gowning, specific instruments for every patient in the department. And she said "no, just the ones you suspect are carrying something".
Sigh. You'd think an infection control-bot would know that you can never know who is carrying what, sweetheart.

7 comments:

Benjamin said...

Hehe. I'm sure you'll prove yourself quickly. Personally I love trying to get report on a patient we're taking for a transfer and you hear, "Well, i'm just a float nurse so I don't know anything about this patient/unit/ED..."

And if things don't get better and they ask why you're there, just tell them you killed a few docs at your last ER for giving you attitude, and are hiding out on the West coast.

Rogue Medic said...

I always try to have something to read when I go anywhere in the hospital. They can ignore me forever, as long as I have something to read. It ruins their power play at the same time, but I don't really care about the games.

You'll make some friends. If they don't warm up to you, maybe you aren't missing anything.

Incompetent infection control people are largely responsible for the hospital acquired infections, that are now becoming common outside of the hospital. Had they done their job to begin with, their job would not be appreciated. Similar to the person who manages an airway without a big deal, while someone else is always trying to deal with disaster airways. Less need for attention and excitement, but generally an indicator of good patient care.

AZReam said...

I think the problem is that you're wearing the wrong color scrubs - obviously not a good way to win friends and influence people. ;)

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It's fun to bank said...

I have been known as 'the little bank nurse' for a year now. It does get frustrating. Luckily on the wards i am most regular on I am a part of the team, but I have sat in handover before after introducing myself as 'bob the bank nurse' and they have still assumed i'm a student because I look so young and they wonder where the qualified they booked is!! It is frustrating but I just try and prove them wrong- and do my job well. Good luck with the shifts to come!!

Albinoblackbear said...

Ben--Agghhh! "Float Nurse" While I was falling asleep this morning I was composing my next posting regarding "float" nurses. Yes, I am still trying to figure out what 'story' to give people...

RM-yesterday someone actually used my real name so I figure I am making progress! And really, don't get me started on infection control practices in the ER (or rather lack thereof). Like a curtain is going to keep the VRE/MRSA at bay--gak!

Azream-yes it is clearly the color of my scrubs...maybe I'll try hot pink. That is nice and feminine and non-threatening...

IFTB-its true. No point in talking the talk, you just have to demonstrate that you know what you're doing without it looking like you are trying to prove yourself. ;)

There is a fine line there I think...

Rogue Medic said...

Albinoblackbear said...

"And really, don't get me started on infection control practices in the ER (or rather lack thereof). Like a curtain is going to keep the VRE/MRSA at bay--gak!"

The curtain doesn't stop the spread of infection, it assists in the spread of infection. Touch the patient touch, the curtain, touch the next patient's curtain, . . . .

Mess with them when JCAHO is around by asking someone to pull the curtain, by saying, "Would you close the fomite."

JCAHO people have such a lovely sense of humor. :-)

Albinoblackbear said...

"Close the fomite"!!!!

That almost resulted in kashi out the nose.

Classic. Maybe I'll start a new blog called that. Hilarity.